CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $71
  • Cash Discount Price: $123
  • vs. Medicare Baseline: 16.55x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at University Medical Center of Princeton at Plainsboro is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 16.55x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$123

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.29

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.29 (100%)
Cash / Self-Pay: $123 (2867%)
Insurance Median: $71 (1655%)
Cash: $123 (2867% of Medicare)
Ins. Median: $71 (1655% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.29 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1655% of the Medicare baseline (a markup of 1555%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $3 - $102 70%
Charity Care $3 70%
Medicaid / KanCare $3 - $123 70%
Wellcare $3 70%
Blue Cross Blue Shield $4 - $93 93%
Cigna $4 - $123 93%
Medicare (plans) $4 - $5 93%
UnitedHealthcare $4 - $29 93%
Va Medical Center $4 93%
Clover Health Plan $5 117%
Horizon Nj Health $5 117%
Humana $5 117%
Tricare $5 117%
Us Family Health Plan $5 117%
Elap $6 - $8 140%
Centivo $8 186%
Claim Watcher $8 186%
Amerihealth $11 256%
Preferred Health Care Eliance $32 746%
Horizon Behavioral Health $46 1072%
Beacon Health Options $62 1445%
Magnacare $74 - $86 1725%
Princeton Theological Seminary $80 1865%
Coventry $86 2005%
Health Net $86 2005%
Beech Street $98 - $105 2284%
Intergrated Health Plan $98 2284%
Intergroup $98 2284%
Penn Global Medicine Embassy Only $98 2284%
Allied Trades $105 2448%
Consumer Health Network $105 2448%
Devon Health Services $105 2448%
First Managed Care Option $105 2448%
Ie Shaffer $105 2448%
Private Healthcare Systems $105 2448%
Qualcare $105 2448%
Total Care Network $105 2448%
Tri-State $105 2448%
Commercial Other $123 2867%
Compsych $123 2867%
Concern Plus $123 2867%
International Pfs $123 2867%
Life St. Francis $123 2867%
Magellan $123 2867%
Managed Health Network $123 2867%
Nj Carpenters $123 2867%
Penn Behavioral Health Corporate Services $123 2867%
Personnel Health Program $123 2867%
United Behavioral Health $123 2867%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals